Phrenic Nerve Cryotherapy for Preventing Prolonged Air Leak During VATS Lobectomy
Background and objective Video-assisted thoracoscopic surgery (VATS) lobectomy is the primary surgical treatment for lung cancer. A significant factor affecting postoperative recovery is prolonged air leak (PAL). Despite numerous clinical strategies could prevent and manage postoperative PAL, its in...
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Chinese Anti-Cancer Association; Chinese Antituberculosis Association
2025-06-01
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| Series: | Chinese Journal of Lung Cancer |
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| Online Access: | http://dx.doi.org/10.3779/j.issn.1009-3419.2025.102.23 |
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| author | Qingyu MENG Yongkun WU Yufei WANG Zhanlin GUO |
| author_facet | Qingyu MENG Yongkun WU Yufei WANG Zhanlin GUO |
| author_sort | Qingyu MENG |
| collection | DOAJ |
| description | Background and objective Video-assisted thoracoscopic surgery (VATS) lobectomy is the primary surgical treatment for lung cancer. A significant factor affecting postoperative recovery is prolonged air leak (PAL). Despite numerous clinical strategies could prevent and manage postoperative PAL, its incidence remains high. Phrenic nerve cryotherapy (PNC) temporarily inhibits phrenic nerve function, causing diaphragm elevation, which reduces thoracic cavity volume, enhances pleural apposition, and mitigates air leakage. This study investigates the efficacy of PNC in preventing postoperative PAL during VATS lobectomy. Methods A total of 108 eligible lung cancer patients who underwent surgery at the Department of Thoracic Surgery, The Affiliated Hospital of Inner Mongolia Medical University, from June 2023 to January 2025, were enrolled and randomly assigned to the control group (n=54) and the experimental group (n=54). The patients in both the two groups received VATS lobectomy and systematic lymph node dissection, with the experimental group also undergoing PNC during the operation. The baseline characteristics, intraoperative, postoperative indicators and dynamic changes in air leakage between the two groups were compared. Results The baseline clinical characteristics were comparable between the two groups (P>0.05). The incidence of pulmonary air leakage at 24 h after surgery (31.5% vs 29.6%) and the incidence of postoperative PAL (20.4% vs 14.8%) showed no significant differences between the two groups (P>0.05). The intraoperative air leak test to 24 hours after surgery revealed that air leakage ceased in 8 cases (32.0%) in the control group, compared to 14 cases (46.7%) in the experimental group. Moreover, during the progression from air leakage at 24 hours post-surgery to postoperative PAL, air leakage ceased in 6 cases (35.3%) in the control group and 8 cases (50.0%) in the experimental group, with a statistically significant difference (P<0.001). Compared to the control group, the patients in the experimental group exhibited more pronounced postoperative diaphragmatic elevation that recovered to a slightly higher than preoperative level by 3 mon after surgery. Conclusion The combination of PNC and active lung repair can serve as an important intervention for patients at high risk of intraoperative air leakage, reducing the occurrence of postoperative PAL. |
| format | Article |
| id | doaj-art-b74df658978342b1b21bfb74775f204b |
| institution | Kabale University |
| issn | 1009-3419 1999-6187 |
| language | zho |
| publishDate | 2025-06-01 |
| publisher | Chinese Anti-Cancer Association; Chinese Antituberculosis Association |
| record_format | Article |
| series | Chinese Journal of Lung Cancer |
| spelling | doaj-art-b74df658978342b1b21bfb74775f204b2025-08-20T03:49:49ZzhoChinese Anti-Cancer Association; Chinese Antituberculosis AssociationChinese Journal of Lung Cancer1009-34191999-61872025-06-0128640541410.3779/j.issn.1009-3419.2025.102.23Phrenic Nerve Cryotherapy for Preventing Prolonged Air Leak During VATS LobectomyQingyu MENG0Yongkun WU1Yufei WANG2Zhanlin GUO3The First Clinical Medical College, Inner Mongolia Medical University, Hohhot 010059, ChinaDepartment of Thoracic Surgery, The Affiliated Hospital of Inner Mongolia Medical University, Hohhot 010050, ChinaDepartment of Thoracic Surgery, The Affiliated Hospital of Inner Mongolia Medical University, Hohhot 010050, ChinaDepartment of Thoracic Surgery, The Affiliated Hospital of Inner Mongolia Medical University, Hohhot 010050, ChinaBackground and objective Video-assisted thoracoscopic surgery (VATS) lobectomy is the primary surgical treatment for lung cancer. A significant factor affecting postoperative recovery is prolonged air leak (PAL). Despite numerous clinical strategies could prevent and manage postoperative PAL, its incidence remains high. Phrenic nerve cryotherapy (PNC) temporarily inhibits phrenic nerve function, causing diaphragm elevation, which reduces thoracic cavity volume, enhances pleural apposition, and mitigates air leakage. This study investigates the efficacy of PNC in preventing postoperative PAL during VATS lobectomy. Methods A total of 108 eligible lung cancer patients who underwent surgery at the Department of Thoracic Surgery, The Affiliated Hospital of Inner Mongolia Medical University, from June 2023 to January 2025, were enrolled and randomly assigned to the control group (n=54) and the experimental group (n=54). The patients in both the two groups received VATS lobectomy and systematic lymph node dissection, with the experimental group also undergoing PNC during the operation. The baseline characteristics, intraoperative, postoperative indicators and dynamic changes in air leakage between the two groups were compared. Results The baseline clinical characteristics were comparable between the two groups (P>0.05). The incidence of pulmonary air leakage at 24 h after surgery (31.5% vs 29.6%) and the incidence of postoperative PAL (20.4% vs 14.8%) showed no significant differences between the two groups (P>0.05). The intraoperative air leak test to 24 hours after surgery revealed that air leakage ceased in 8 cases (32.0%) in the control group, compared to 14 cases (46.7%) in the experimental group. Moreover, during the progression from air leakage at 24 hours post-surgery to postoperative PAL, air leakage ceased in 6 cases (35.3%) in the control group and 8 cases (50.0%) in the experimental group, with a statistically significant difference (P<0.001). Compared to the control group, the patients in the experimental group exhibited more pronounced postoperative diaphragmatic elevation that recovered to a slightly higher than preoperative level by 3 mon after surgery. Conclusion The combination of PNC and active lung repair can serve as an important intervention for patients at high risk of intraoperative air leakage, reducing the occurrence of postoperative PAL.http://dx.doi.org/10.3779/j.issn.1009-3419.2025.102.23lung neoplasmsvideo-assisted thoracoscopic lobectomyphrenic nerve cryotherapyprolonged air leak |
| spellingShingle | Qingyu MENG Yongkun WU Yufei WANG Zhanlin GUO Phrenic Nerve Cryotherapy for Preventing Prolonged Air Leak During VATS Lobectomy Chinese Journal of Lung Cancer lung neoplasms video-assisted thoracoscopic lobectomy phrenic nerve cryotherapy prolonged air leak |
| title | Phrenic Nerve Cryotherapy for Preventing Prolonged Air Leak During VATS Lobectomy |
| title_full | Phrenic Nerve Cryotherapy for Preventing Prolonged Air Leak During VATS Lobectomy |
| title_fullStr | Phrenic Nerve Cryotherapy for Preventing Prolonged Air Leak During VATS Lobectomy |
| title_full_unstemmed | Phrenic Nerve Cryotherapy for Preventing Prolonged Air Leak During VATS Lobectomy |
| title_short | Phrenic Nerve Cryotherapy for Preventing Prolonged Air Leak During VATS Lobectomy |
| title_sort | phrenic nerve cryotherapy for preventing prolonged air leak during vats lobectomy |
| topic | lung neoplasms video-assisted thoracoscopic lobectomy phrenic nerve cryotherapy prolonged air leak |
| url | http://dx.doi.org/10.3779/j.issn.1009-3419.2025.102.23 |
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